Abstract
Background: Surfactant (SF) therapy in RDS hasreduced mortality and morbidity in preterm infants. Although adverse-effects seem to be moderate, fluctuation in cerebral circulation has beenobserved. Cerebral haemodynamic changes duringpartial-liquid-ventilation (PLV) have not been welldescribed.
Aim: To evaluate the effect of SF and PLV treatmenton oxygenation and on cerebral haemodynamic inpremature lambs with RDS.
Methods: 18 preterm lambs (80-90%GE) wererandomly assigned to: SF-Group, receivedCurosurf®(175mg/kg), PLV-Group, treated withperfluorocarbon(30ml/kg) or Control-Group. Systemic-arterial-pressure (SAP), heart rate(HR), oxygenation-index (OI) and arterial/alveolar-index(a/ADO2) were determined during 3hours. Regionalcerebral-blood-flow (RCBF) was determined bymicrospheres-technique at foetal point (F), 1h andat 3h. Cerebral cortexes and periventicular zones(striatum, thalamus, hypothalamus, hippocampus)were grouped. Mean±SEM;Two-factor-ANOVA, p<0.05.
Results: Fetal blood gases were similar betweengroups (pH:7.30±0.07, PaCO2:47±9mmHg, PaO2:27±6mmHg). After 5-min of conventionalmecanical-ventilation a severe RDS was developedin all groups (IO>70, a/ADO2< 0.1), that wasmaintained stable in Control-Group throughoutthe experiment. SF and PLV treatments showedsignificant improvement of gas exchange (IO:6±2and a/ADO2:0.38±0.05, at1h). However, only SFtreatment sustained this improvement along thetime. HR and SAP remained stable.
Conclusion: In SF and PLV treatment carefulmonitoring of pulmonary and cerebral haemodynamicstatus and cautious corrections of ventilator settingsare mandatory to avoid alterations of RCBF. Supported:GV2007111046-FIS070733.
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Rey-Santano, C., Mielgo, V., Murgia, X. et al. 1332 Effect of Surfactant and Partial Liquid Ventilation Treatment on Cerebral Haemodynamic and Oxigenation in Premature Lambs. Pediatr Res 68 (Suppl 1), 659 (2010). https://doi.org/10.1203/00006450-201011001-01332
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DOI: https://doi.org/10.1203/00006450-201011001-01332